Comparison of Three Screening Methods for Cervical Cancer in China - A Systematic Study of 3,300 Cases in Rural Areas of Shanxi Province

Objective: Reaching women in rural China is one of the major public health problem today and even though various methodologies were introduced they had limited or no success. The goal of our study was to investigate the usefulness of DNA quantitative assessment (ploidy) in comparison with conventional cytology (LBC) and HPV testing and its possible role in the clinical practice for rural women. Methods: In collaboration with Shanxi Women and Children Health Center we finished a study in Shanxi Province (3300 women) using Image cytometer. Each women underwent HPV testing, liquid based cytology screening (LBC) using manual and semi-automated analysis based on DNA ploidy and EA50 staining (on the same slide). All positive cases by any method were invited for colposcopy and biopsy. Results: Our results showed that DNA ploidy in combination with EA50 have superior performance in comparison with LBC or HPV method. Conclusion: Automated combined qualitative and quantitative image cytometry is a very good candidate for screening in low resource settings in China where the conventional cytology or LBC reading cannot be performed due to the lack of adequate infrastructure and trained cytotechnologists or cytopathologists. Furthermore digitalization of images open a door for data transfer and cloud computing which in turn can improve access to proper medical care in rural China.